Sadeghi Elham, Vupparaboina Sharat Chandra, Bollepalli Sandeep Chandra, Vupparaboina Kiran Kumar, Agarwal Komal, Sahel Jose-Alain, Eller Andrew W, Chhablani Jay
Department of Ophthalmology, University of Pittsburgh School of Medicine, 3550 Terrace St, Pittsburgh, PA, 15213, USA.
School of Computing, Wichita State University, Wichita, KS, USA.
Graefes Arch Clin Exp Ophthalmol. 2025 Jan;263(1):77-86. doi: 10.1007/s00417-024-06605-8. Epub 2024 Aug 23.
Incidence and risk factors of fellow eye wet conversion in unilateral neovascular age-related macular degeneration (nAMD) over 15-years follow-up.
This retrospective study reviewed 593 unilateral nAMD patients with a minimum of five years up to 15 years of follow-up. The demographic data, visual acuity, fellow eye nAMD conversion rate, and the number of anti-vascular endothelial growth factor (anti-VEGF) injections in the primary eye were evaluated. Also, the nAMD-converted fellow eyes were divided into two groups based on the time of conversion (less and more than two years from the first injection in the primary eye). Based on the data types, the T-test, Chi-square, and Mann-Whitney U test were used to analyze.
The total cases were 593 patients, and 248 eyes (41.82%) converted to nAMD in the mean interval of 34.92 ± 30.62 months. The males exhibited a predisposition to wet conversion at 2.54 years earlier than their female counterparts (P = 0.025). In all the converted fellow eyes, the mean age was 2.3 years higher at presentation in the group who converted within two years of follow-up in compared to eyes that converted after two years (79.82 ± 8.64 vs 77.51 ± 8.5 years, P = 0.035). Additionally, eyes converting within two years had a mean baseline LogMAR visual acuity of 0.44 ± 0.47, compared to 0.32 ± 0.41 for conversions after two years (P = 0.014).
This study reported that males showed a predisposition to fellow eye nAMD conversion at an earlier age. Additionally, there was a trend of faster fellow eye nAMD conversion in individuals with higher age and lower baseline visual acuity.
What is known • Certain risk factors may make the fellow eye of neovascular age-related macular degeneration (nAMD) more likely to progress to wet conversion. • Identifying these risk factors for fellow eye wet conversion can help prevent it, potentially preserving the patient's vision quality for a longer duration. • The studies on the incidence of wet conversion in the fellow eye have yielded controversial results. What is new • During the 15-year follow-up period, nearly half (47.58%) of the fellow eyes that underwent wet conversion did so within the initial two years following the wet conversion of the first eye. • Males showed a predisposition to fellow eye nAMD conversion at an earlier age. • There was a trend of faster fellow eye nAMD conversion in individuals with higher age and lower baseline visual acuity.
在15年的随访中观察单侧新生血管性年龄相关性黄斑变性（nAMD）患者对侧眼湿性转化的发生率及危险因素。
这项回顾性研究纳入了593例单侧nAMD患者，随访时间至少5年，最长达15年。评估了人口统计学数据、视力、对侧眼nAMD转化率以及患眼抗血管内皮生长因子（anti-VEGF）注射次数。此外，根据转化时间（从患眼首次注射起少于2年和多于2年）将发生nAMD转化的对侧眼分为两组。根据数据类型，采用t检验、卡方检验和曼-惠特尼U检验进行分析。
总共有593例患者，248只眼（41.82%）发生了nAMD转化，平均间隔时间为34.92±30.62个月。男性比女性更容易发生湿性转化且早2.54年（P = 0.025）。在所有发生转化的对侧眼中，与随访两年后发生转化的眼相比，随访两年内发生转化的组中，转化时的平均年龄高2.3岁（79.82±8.64岁 vs
77.51±8.5岁，P = 0.035）。此外，两年内发生转化的眼的平均基线LogMAR视力为0.44±0.47，而两年后发生转化的眼为0.32±0.41（P = 0.014）。
本研究表明男性在较早年龄时对侧眼更易发生nAMD转化。此外，年龄较大且基线视力较低的个体对侧眼nAMD转化有更快的趋势。
已知内容•某些危险因素可能使新生血管性年龄相关性黄斑变性（nAMD）的对侧眼更易进展为湿性转化。•识别这些对侧眼湿性转化的危险因素有助于预防，可能使患者的视力质量在更长时间内得到保留。•关于对侧眼湿性转化发生率的研究结果存在争议。新发现•在15年的随访期内，近一半（47.58%）发生湿性转化的对侧眼是在患眼首次发生湿性转化后的最初两年内发生转化的。•男性在较早年龄时对侧眼更易发生nAMD转化。•年龄较大且基线视力较低的个体对侧眼nAMD转化有更快的趋势。
